— 降低風險 · EASY · MCQ —
護理師照護一位髖關節置換術後的病人，下列哪項措施對於預防術後靜脈血栓栓塞（VTE）最有效？
A nurse is caring for a client who is post-operative following a hip arthroplasty. Which action is most effective in preventing postoperative venous thromboembolism (VTE)?
- AApply sequential compression devices (SCDs)使用間歇性加壓裝置 (SCDs)
- BAdminister prophylactic anticoagulants as prescribed✓ 正解依醫囑給予預防性抗凝血劑
- CEncourage deep breathing and coughing鼓勵深呼吸與咳嗽
- DMaintain strict bed rest for 48 hours嚴格臥床休息 48 小時
— Explanation · 中文詳解 —
對於髖關節置換術後的高風險病人，藥物預防（如低分子量肝素或阿斯匹靈）是目前實證醫學中預防 VTE 最核心的手段。雖然機械性措施（SCDs）有效，但對於高危險手術，藥物治療效果更為確切。長期臥床反而會增加血栓風險。
Prophylactic anticoagulants are the most effective method for preventing venous thromboembolism in high-risk orthopedic patients, as supported by evidence-based practice. While mechanical devices like SCDs are useful adjuncts, pharmacological intervention remains the gold standard for this population.
✦ 台美臨床差異
美國醫院針對骨科術後常有制式的藥物預防協定；台灣臨床則更重視 SCD 使用與早期下床，藥物給予視醫師習慣而定。